Flat Knit vs. Circular Knit Compression

When I first heard about flat knit vs. circular knit, I was oblivious to my Lipedema condition, and the graduated compression I would need to wear for the rest of my life to manage it.

I heard these terms many years before my diagnosis when I was learning how to knit. 

The easiest way to learn how to knit is just that, the knit stitch (vs. pearl, but that is a post for another day, and another blog). The easiest tools when first learning to knit are straight needles, which will produce a flat knitted garment, think scarf.

Straight & Circular needles

But once you learn the stitches, and you have made a scarf (or 12), you start dreaming of making hats, mittens, and socks, and you get introduced to circular needles, and what is called knitting in the round. This becomes faster and easier for a lot of knitters. No sewing the pieces together, it comes off the needles seamless.

So, how does all this knitting talk tie in with graduated compression?

Well, thankfully we don't have to knit our own compression garments, we have specialty vendors to make them for us, and just like knitting, they can produce either flat knit (custom) or circular knit (off the shelf) options.

So, what are the differences?

Micro-massaging

Circular Knit - 

• Comes off the machine in a tube (Seamless)
• Off the shelf product (comes in ready-to-wear sizes)
• Can buy online (once you know your size)
• Available in fun colors/patterns
• Thinner, and moves well when active
• Can be tricky to fit if you have lobules
• Not good to sleep in, can bind and cause damage

Flat Knit - 

• Comes off the machine flat (like a piece of fabric)
• Custom made to your measurements (will have seams)
• More rigid
• Thicker
• Less likely to bind (hurt) at knee and ankle creases
• Higher containment
• Safer to wear at rest

When I was first diagnosed in 2007, the options were custom (flat knit), where they take your measurements and specially make your garment, or off the shelf (circular knit), where you take your measurements and match it up to a vendor’s size chart. 

Custom are expensive, mine were close to $1000 for one garment (full foot to waist), which for me, insurance did not cover. I purchased once, and found it not tolerable for me. It felt very restrictive, I could barely walk in them, and when I did they felt like they were pulling me down (physically and emotionally). I tried having them cut into thigh highs and a short, which was a lot better, much easier to get on, but the thigh highs did not stay up, so again, an issue for walking, let alone a workout. I opted for the off the shelf (thankfully my measurements fell within the parameters, and they were more like $90 a pair (for knee highs). The knee highs are good for about 6 months, mine are Juzo dynamic model, and I can wash them in a washing machine and dry them in the dryer. They are latex free, and laundering them brings them back into shape. While I don’t have coverage under my insurance for them, I can purchase on an FSA (medical flexible spending account through my husbands employer).

Later on new micro-massaging garments started coming out. They are not as much compression,12-18mmHg (compression is measured in millimeter of mercury) vs. my knee highs which are 30-40mmHg, but have a special weave that helps to move your lymphatics when you move in them. I add these (I buy the bioflect line) to my knee highs for all my workouts, the are ankle to just under my sports bra, and they are easy to squat in. 

The combo works for me, and that’s the most important takeaway, find what works for you, even if that means going a little lower on the compression strength to be able to do what you want to do, wearing something is better than wearing nothing.

The latest technology I’ve seen is adding FIR (far-infrared therapy) to the micro-massaging garments,  There are special minerals woven in, that works with your body heat to go deeper, claiming it can help with joint and ligament and muscle pains, and so much more. Fascinating stuff to investigate into more. 

Micro-massaging garments are circular knit, you take measurements and apply them towards the vendors size chart to know what to order (off the shelf).

Compression is a huge part of caring for Lipedema and Lymphedema. A couple years ago I had the pleasure of touring Juzo’s headquarters and seeing firsthand how compression is made, after you witness all the work that goes into a single pair of knee highs, you understand the cost, I just wish insurance companies would do the right thing and start covering them.